The Transsexual Script
By Dallas Denny
There's no doubt that analogs of modern-day transsexuals have occurred all through history. A wide variety of anthropological and historical sources document this (cf Feinberg, 1996; Roscoe, 1990; Taylor, 1996). It's of course not possible to determine whether a female-bodied Paleolithic warrior or a male-bodied Cheyenne two-spirit ca 1700 would have called themselves transsexual, had the term been available, but case studies from two pre-transsexual era works, Krafft-Ebing's 1894 Psychopathia Sexualis and Hirschfeld's 1910 Die Transvestiten, leave little doubt that some of the individuals studied would have availed themselves of hormonal therapy and sex reassignment surgery, had they been born a half-century or so later.
The Benjamin Model
When the news of Christine Jorgensen's "sex change" shocked the world in 1953, hundreds of men and women wrote to Jorgensen and her physicians asking for the same treatments she had had (Hamburger, 1953). These were people who had been getting through life, somehow, without any real notion that it was possible to change sex. Jorgensen opened new vistas for them, allowing them to glimpse a future heretofore closed to them, one in which they could be changed in the same way as she. With this door opened, some of the letter writers walked the same road as Jorgensen, and changed gender roles. Soon, a new term was used to describe these people who changed their sex. They came to be known as transsexuals.
In 1966, Dr. Harry Benjamin, a New York endocrinologist who had worked with a large number of transsexuals, published a text, The Transsexual Phenomenon, in which he told the world about transsexualism. Benjamin, an empathetic man who seemed to really like his transsexual patients, described them as desperately unhappy souls who were profoundly miserable in their gender of original assignment. So much so that they were often unable to function and were at considerable risk of taking their own lives. Benjamin noted that medical science was unable to rid them of their compelling desire to change their sex or give them peace of mind in their original bodies. Surely, he argued, the humane thing--in select cases, mind you--would be to give transsexuals access to hormones and surgery which would alleviate their suffering by altering their bodies, allowing them to live as members of the other sex. Benjamin pointed out the success of his own patients who had had sex reassignment.
Three years later, in 1969, Drs. Richard Green and John Money published an edited textbook which established a medical protocol for sex reassignment, based on their own experience at the new gender identity clinic at Johns Hopkins University. It provided a methodology for Benjamin's model, spelling out the mechanics of changing sex, from how to set up a gender clinic to electrolysis to hormonal therapy to sex reassignment surgery.
Now there was not only a model for transsexualism, but a sex reassignment protocol from one of the most prestigious medical schools in the United States. Other universities started gender programs; within 10 years, there were more than 40 such programs scattered across the U.S. When these programs all closed in 1979 and 1980 (as a result of intrigue and duplicity at Hopkins, a story I will tell in a future column), a market-driven sex-change industry began to arise in the United States (Denny, 1992). It is this industry which has brought us the present slate of sex reassignment surgeons, therapists, and other professionals to whom we go for treatment.
Being a "Good" Transsexual
The Benjamin model required that one subscribe to a narrow definition of transsexualism. Those who varied from the prescribed characteristics were at risk of not getting treatment, in fact, of being declared non-transsexual by medical professionals and by their peers. Transsexuals were believed to be imbued with a certain something that differentiated them from non-transsexuals. To be presumed to have this special transsexual spark, it was important that one's gender dysphoria manifest at a young age, preferable by age 3 or 4; that one remember having played with dolls as a child if born male, or with trucks and guns if born female; that one be sexually attracted only to the same biological sex; that one be unsuccessful in the original gender role; that one be able to pass successfully as a member of the non-natal sex [1, 2]; that one have narrow and stereotyped notions of masculinity and femininity and conform to those stereotypes in one's personal presentation; that one desire to disappear into the woodwork after surgery [3]; and, of course, that one view oneself as born into the wrong body and, because of some sort of birth defect or horrible joke of nature, as "truly" a member of the other sex. Most of all, one had to be thoroughly miserable if one was to be a proper transsexual. [4, 5]
The Transgender Model
The Benjamin model of transsexualism held supreme until the early 1990s. It was questioned on a number of fronts--by psychiatrists like Charles Socarides (1969), who argued bitterly that the proper way to treat a mental illness was by curing it, not giving in to it; by feminists, who found it patriarchal and anti-woman (see especially Raymond, 1979), and perhaps most notably by Sandy Stone, whose essay "The Empire Strikes Back: A Post-transsexual Manifesto" questioned the accuracy of the clinical literature which stereotyped transsexuals. Stone pointed out that because clinicians were looking for "true transsexuals" who fit narrow diagnostic criteria, transsexuals learned to lie to their doctors, telling them whatever was necessary in order to qualify for medical treatment. Often, transsexuals internalized these "rules," making them part of their self-definition. Transsexuals, Stone argued, worked hard to fit the description of what they were supposed to be--by following a transsexual script, if you will (see also Bolin, 1988).
Benjamin's model supposed that there were only two sexes, and that the only alternative to remaining an unhappy camper in the original gender role was to work hard to conform to the other. That is, one "changed sex," going from male to female, or from female to male. The model did not question the society which created such restrictive gender roles or examine the possibility of living somewhere outside those roles. Those who did not fit the model--those who were not interested in going from one polar extreme to the other--were defined as non-transsexual and were presumed to be crossdressers, although many of them were profoundly gender dysphoric. Transsexualism itself was a liminal state, a transitory phase, a necessary evil which had to be negotiated (as rapidly as possible) on one's way to becoming a "normal" man or "normal" woman.
The '90s saw the rise of an alternative to Benjamin's transsexual model, the emergence of a transgender sensibility in which the notion of changing sex was replaced by the idea of a gender continuum in which gender variance was something to be celebrated rather than an illness to be cured by changing sex (Boswell, 1991). Transgendered people see themselves not as non-transsexual men or women, but as a bit man and a bit woman, or as both, or neither, or as transsexual men or women, or as something else entirely. Under this model the in-between state somewhere between manhood and womanhood, considered so intolerable by Benjamin's model, becomes not a no-man's land to be crossed, but a final resting place, a goal for which to strive. The transgender model holds that one is transgendered, and regardless what one decides to do about it, one will always be transgendered.
The transgender model legitimized all those folks who did not fit comfortably in the limited number of gender boxes which had heretofore been open to them. Gender-variant people were no longer forced to choose restrictive transsexual or crossdresser or drag queen roles, each with its own behavioral script laid down in stone. New vistas were opened. Suddenly it was possible to transition gender roles and keep one's original plumbing, to acknowledge one's gender dysphoria and yet remain in one's original gender role, to take hormones for a while and then stop, to blend genders as if from a palette. It was possible, and even preferable, to be out and proud, rather than fearful and closeted.
The New Transsexualism
Transsexuals reacted to the new transgender model in a variety of ways. Some were appalled. They considered they had nothing in common with those transgendered people, those people "stuck in the middle." They clung to the Benjamin model. Other transsexuals embraced the transgender model, rejecting the notion that they were "sick" and that sex reassignment was the only possible solution for them and other transsexuals. Not surprisingly, those who had lived longest with the Benjamin model were most resistant to change, but even some old-timers embraced the transgender model.
Today, there is a new transsexualism. Those new to the community, exposed to both the Benjamin and transgender models on the internet and at support group meetings, tend to subscribe to the transgender model. Many of these folks self-identify as transsexual as well as transgendered, and certainly they take all of the steps taken by transsexuals under Benjamin's model, including hormonal therapy, gender role change, and sex reassignment surgery. They differ from Benjamin-era transsexuals in that they tend to be less frantic about having surgery, less concerned with passing, do not "disappear into the woodwork" because they do not care who knows they are transsexual, do not try to conform to "proper" notions of manhood or womanhood, and are less likely to disavow their pasts and more likely to maintain their ties to their previous lives. They are inclined to view their transition as a logical choice rather than as something they "had" to do.
Good or Bad?
Has the rise of the transgender movement been good or bad for transsexuals? I would argue, based on my own experience, that it's the best thing that could possibly have happened. [6] Transsexuals are increasingly coming to see themselves as healthy individuals and not as unfortunates "born into the wrong body." The long-term implications of this are quite profound, and will impact not only the role of transsexuals in society, but will probably ultimately insure the freedom of transsexuals to modify their bodies. That's because under the old model, transsexuals viewed themselves and were viewed by others as having an incurable mental illness which could be made more bearable by sex reassignment; under the new model, transsexuals see themselves and are increasingly coming to be seen by others as healthy people who change their sex because, considering how they feel about themselves, it is a logical decision.
While the mental illness model provided a measure of social acceptance in past decades, it has built-in limitations, the most important of which is that it removes autonomy from transsexuals and gives it to medical and psychological professionals, who serve as gatekeepers. One does not change oneself; one is changed by others, and only with their permission. And moreover, one is defined by the professionals. You are transsexual only if the doctor says you are. Transsexualism remains firmly in the medical realm.
While the Benjamin model legitimized sex reassignment, it also limited it. Sex reassignment was only for a select few. For everyone else--and that in all certainty means you, gentle reader, and me as well--access to medical treatments like hormones and surgery was forever withheld. [7]
The transgender model released transsexuals from the Benjamin script. Under the new model, transsexualism became a political matter rather than a medical one. This raised the stakes by an order of magnitude. The tremendous gains of the '90s in employment and other civil rights protections were manifested by our entry into the political playing arena. They would never have happened had the transgender model not arisen.
It's because of gains already manifested and because of greater gains yet unrealized that I support the transgender model. It lets us see ourselves and helps others to see us as healthy and whole, and that is a good thing. I also support it because it does not illegitimize anyone. Everyone can play this game, defining themselves however they please--even those who view themselves through Harry Benjamin lenses.
End Notes
[1] It's belief in this "special transsexual spark" that I think makes it impossible for certain transgender community leaders to understand my viewpoint about gender dysphoric crossdressers. They seem to think that transsexuals are imbued with a certain je ne sais quois that differentiates them from crossdressers, even if those crossdressers take hormones, transition gender roles, and live as women (as many "crossdressers" do). I have argued that functionally such folks are no different from pre-op transsexuals and suggested that membership policies which exclude transsexuals while embracing such "crossdressers" are hypocritical, or, as I called it, heteropocritical. When said leaders responded to my critique with heat rather than light, I sent in an application to one organization as a "post-op" crossdresser. I thought it was funny. They didn't.
To date, my question remains unanswered. I will again pose it, in the faint hope that someone in a position of authority will answer it: What is the difference in a cross-living, hormone-taking, gender dysphoric crossdresser, and a cross-living, hormone-taking, gender dysphoric transsexual who has not yet had (and might never have) surgery? A shiny Susan B. Anthony dollar to the first response from an officer or board member of a certain national crossdressing organization.
[2] Conventional transsexual wisdom held that if you were really transsexual, that special inner spark would make you pass even if you were a 4'10" man or a 6'7" woman. Yeah. Right.
[3] Maintaining a reputation as non-transsexual leaves one vulnerable to being outed, and can be extremely stressful due to the very real fear of having one's life fall apart because of discovery. I once received a help line call from a distressed transsexual woman who dealt blackjack in Las Vegas. Here is what she said: "A month ago, someone from my home town walked up to my table. He didn't recognize me, but now I find myself cringing whenever anyone comes through the casino door. My supervisor knows something is bothering me, but I can't tell him what it is. And I just know my boyfriend is on the verge of figuring me out. He wants to know why we always have to use lube when we're having sex. He's the kind of guy that would kill me if he found out." So much for having a "normal life" after sex reassignment!
[4] We transsexuals have traditionally defined ourselves by our pain. Every single one of the 50 or so transsexual autobiographies I have read focus on the anguish the author felt before transition. Certainly, the pain was real, but what of their joy? Why do we never write about our joy?
[5] I have an acquaintance, an FTM, who subscribes fully to the Benjamin model. According to him, his entire life to this point (i.e., the last 55 years) has been a sham, nothing but a sham. He goes about sighing and saying wistfully, "I can't wait until... these hormones start to work... I have my top surgery... I have my bottom surgery... I start my new life." He avoids his adult children and his ex-husband because they remind him of that "other person." He stays away from the support group because it is full of all those "stuck in the middle" people, and despite the acceptance of his family and employer, plans after transition to move to another city to start "a new life." He is so preoccupied with the future that he is unable to enjoy a not-unpleasant present, and so busy with his breast beating that he does not see how very fortunate he is to have so much support. Worst of all, in his own misery, he is stomping on the hearts of those who love him.
[6] My Own Experience: It was 1990. As the director of the only national organization with a mission to serve transsexuals, I found myself in a unique position. Was I really transsexual? I had been thoroughly indoctrinated in the Benjamin model, and had done my best to conform to it. But when I was honest with myself, it wasn't a really good fit. I had not been wanted to be a girl from earliest memory, but only from age 13 or so. As a child, I had not played with dolls. Nor was I desperately unhappy. My dysphoric feelings, although strong and persistent, had not been such that I could not have controlled them and lived the balance of my life in the male role. I was certainly unhappy, but I could have muddled through. I was not suicidal, nor did I engage in self-destructive behaviors, with the exception of overeating. I was not unsuccessful in the male role; I knew the rules, and could do a reasonably good job of following them. I did not hate being male; rather, I wanted to be female. By the criteria of the Benjamin model, I was probably non-transsexual, I thought--but if I was non-transsexual, then why did I want so to be a woman? And when I transitioned, why was womanhood such a good fit? Why was I so comfortable with myself as a woman, and why were others so comfortable with me? Why did I pass so easily? Why was I so delighted by the changes wrought by hormones, electrolysis, and surgery? And why did I have no regrets?
The (fortunately now defunct) transsexual support group I attended was no help. It was geared primarily to ferreting out those who were not "true transsexuals," and much time and energy was spent in doing so. During the year or so I facilitated the group, I was approached by almost every member, who wished to denounce another member of the group as non-transsexual. Every single member of the group got it from someone. No one was spared, myself included. Jana was "just" a crossdresser; if she were really a transsexual, she would not have waited until she was 40 to begin her transition. Martha was a drag queen, obviously, because she was so theatrical, and so good with her makeup. Bruce was a lesbian in denial; how could I doubt that, since he did not act mean and nasty, like so many men? Ruth was a gay boy who liked dressing up. Henry had been married to a man and given birth to a child. Marcel looked masculine enough, but he liked to cook and sew. How could he be a man? Ya da ya da ya da.
At some point I realized that transsexuals did not have some special inner spark that differentiated them from other gender-variant people. Transition was not an inevitability if one was transsexual; rather, it was something one thought about and did if it made sense in one's life, if, on the balance, it was a better decision than remaining in one's original role. In fact, one could be transsexual without transitioning.
It was a revelatory understanding. In one fell swoop, the transsexual hierarchy was wiped out. Now, those who passed were no longer superior to those who did not. Those who were lesbian or gay in the new role were not less transsexual than those who were "heterosexual," for the transgender model made it clear just how meaningless terms like heterosexuality and homosexuality are when applied to transsexuals. Those who chose to transition were no longer superior to or "more transsexual than" those who chose, for whatever reason, not to. And most importantly, transsexualism was no longer an unfortunate transitional state, but something to be celebrated. I realized that I was proud of being transsexual, and that I had very little desire to or stomach for pretending to be something that I was not--that is, nontranssexual.
[7] To see what happens when a society does not transcend the Benjamin model, one need only look to the Scandinavian countries. In Sweden, which has a transsexual law, only those selected by a committee of doctors are eligible for treatment; others have no recourse but to remain in the original gender. They are not even permitted to change their name.
Dallas Denny
American Educational Gender Information Service, Inc. (AEGIS)
P.O. Box 33724
Decatur, GA 30033-0724
770-939-2128
aegis@gender.org
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